Some of you reading this article might be thinking that “I’m already cultural and/or linguistically diverse” and that may be true from whatever or where ever your family background may include. But speaking from experience, nothing quite prepares you for when a child and their family comes into your office, clinic, hospital or school seeking therapeutic services and some of the following scenarios come into play: (1) they don’t look and/or sound like you, (2) they may even not share the same native language as you, (3) something that you did or could do might invalidate an evaluation performance/score or insult a student or family member (i.e., depending on the client’s culture -- asking a direct question, looking/staring directly into a client’s eyes during testing, developing a treatment plan that goes against traditional cultural values, etc.). What would you do then?
Therefore, I have compiled a few considerations for SLPs when working with CLD populations, especially in the schools:
- Cultural competence:
Again, SLPs must develop and maintain cultural competence in order to deliver effective service delivery to all clients from culturally and/or linguistically diverse backgrounds. The American Speech-Language-Hearing Association (ASHA) asserts that “developing cultural competence is a dynamic and complex process requiring ongoing self-assessment and continuous expansion of one's cultural knowledge” (2018). In addition, ASHA provides the following self-assessments to evaluate our own cultural competence related to: Personal Reflection, Policies & Procedures, and Service Delivery. I encourage all who read this to take the self-assessments. The best part is that it’s not like the Praxis or dreaded comprehensive exams, there’s no right or wrong answer! Yay! Link: https://www.asha.org/practice/multicultural/self.htm
- Be aware of speech-language characteristics of CLD clients a.k.a., DIALECTS:
Besides Mainstream American English (i.e., there are 10 major dialects of MAE), other common dialects of American English that SLPs typically encounter are: African American English (AAE), Spanish-Influenced English, English Influenced by Asian languages. Also, be aware of some misconceptions about dialects. For instance, only specific dialects are spoken by certain populations ONLY (AAE is spoken by African Americans, Spanish-Influenced English is spoken by Hispanic/Latino speakers, etc.), standardized tests are the ONLY and most accurate form of assessment for dialectal speakers (many standardized tests of morphosyntactic skill are biased against some dialects), and so on.
- What’s a language difference versus language learning disability/disorder?
Typically, the rule of thumb has been: (1) if the child has a disorder in BOTH languages (L1 – native and L2 – 2nd language) then that child has a communication (language and/or speech) disorder or (2) if the child’s native language skills are fine, but has difficulty in acquiring their 2nd language – this student is not language or speech impaired and may benefit from other services, such as bilingual education.
- Be wary of standardized tests!
You’re probably thinking, “but they’re so convenient for a busy school SLP.” Trust me, I know the struggle. However, standardized tests have historically been known for carrying hidden bias’s when used to evaluate CLD populations – primarily because most of these tests did grow out of the framework of including many if any CLD populations. If you do administer a standardized test when assessing the CLD population – consider some of the following: test beyond the ceiling, omit biased items that the client will probably miss, give extra examples, rephrase confusing directions, and so on.
- Alternatives to Standardized Tests:
Conduct a comprehensive assessment to include, obtaining a thorough case history, use narratives, observe in a naturalistic environment, if possible; use language samples, collect student works in portfolio method of assessment, and/or a dynamic approach to assessment (test-teach-retest over an extended period, if possible).
- Treatment considerations:
Ultimately, a bilingual and/or bidialectal approach in remediating both the primary and secondary language/dialect is ideal and effective for CLD populations. Yet, that approach may not be ideal in all situations.
For students: if CLD students qualify for speech-language services in the schools: considering some of the following service delivery options: placement in a regular bilingual or ESL classroom with support from special education principles (i.e., traditional pull-out support in English), consultative or collaborative with push-in support with the general education teacher, bilingual teacher aid, etc.
In closing, ASHA and it’s Office of Multicultural Affairs continues to work diligently to provide SLPs like me and you with current and relative information regarding position statements and guidelines regarding service delivery to CLD clients. More information can be learned by connecting with SLP colleagues and other professionals working with CLD populations by joining Special Interest Group 14, Cultural and Linguistic Diversity: https://www.asha.org/SIG/14/
Author: Stephanie N. Austin, M.S., CF-SLP